Background and Objectives: To examine the effect of conditional survival on 5-year cancer-specific survival (CSS) probability after radical nephroureterectomy (RNU) in a contemporary cohort of patients with non-metastatic urothelial carcinoma of the upper urinary tract (UTUC). Methods: Within the Surveillance, Epidemiology and End Results database (2004-2015), 6826 patients were identified. Conditional 5-year CSS estimates were assessed after event-free follow-up duration. Multivariable Cox regression (MCR) models predicted cancer-specific mortality (CSM) according to event-free follow-up length. Results: Overall, 956 (14.0%) were T1low grade(LG)N0, 1305 (19.1%) T1high grade(HG)N0, 1215 (17.8%) T2N0, 2249 (32.9%) T3N0 and 1101 (16.1%) T4N0/TanyN1-3. From baseline, 93.4% to 94.2% in T1LGN0 provided 5-year CSS and, respectively, 86.2% to 95.3% in T1HGN0, 77.5% to 87.8% in T2N0, 63.0% to 91.1% in T3N0, and 38.8% to 88.2% in T4N0/TanyN1-3. In MCR models, relative to T1LGN0, T1HGN0 (Hazard ratio [HR] 1.7), T2N0 (HR 3.0), T3N0 (HR: 5.2), and T4N0/TanyN1-3 (HR 11.9) were independent predictors of higher CSM. Conditional HRs decreased to levels equivalent to T1LGN0 at 3 years vs 5 years of event-free survival for T1HGN0 and all other groups, respectively. Conclusions: A direct relationship exists between event-free follow-up and survival probability after RNU. From a clinical perspective, such survival estimates may have particular importance during preoperative counseling.

Contemporary conditional cancer-specific survival after radical nephroureterectomy in patients with nonmetastatic urothelial carcinoma of upper urinary tract / G. Rosiello, C. Palumbo, S. Knipper, A. Pecoraro, S. Luzzago, M. Deuker, F.A. Mistretta, Z. Tian, N. Fossati, A. Gallina, F. Montorsi, S.F. Shariat, F. Saad, A. Briganti, P.I. Karakiewicz. - In: JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0022-4790. - 121:7(2020), pp. 1154-1161. [10.1002/jso.25877]

Contemporary conditional cancer-specific survival after radical nephroureterectomy in patients with nonmetastatic urothelial carcinoma of upper urinary tract

S. Luzzago;F.A. Mistretta;A. Gallina;F. Montorsi;
2020

Abstract

Background and Objectives: To examine the effect of conditional survival on 5-year cancer-specific survival (CSS) probability after radical nephroureterectomy (RNU) in a contemporary cohort of patients with non-metastatic urothelial carcinoma of the upper urinary tract (UTUC). Methods: Within the Surveillance, Epidemiology and End Results database (2004-2015), 6826 patients were identified. Conditional 5-year CSS estimates were assessed after event-free follow-up duration. Multivariable Cox regression (MCR) models predicted cancer-specific mortality (CSM) according to event-free follow-up length. Results: Overall, 956 (14.0%) were T1low grade(LG)N0, 1305 (19.1%) T1high grade(HG)N0, 1215 (17.8%) T2N0, 2249 (32.9%) T3N0 and 1101 (16.1%) T4N0/TanyN1-3. From baseline, 93.4% to 94.2% in T1LGN0 provided 5-year CSS and, respectively, 86.2% to 95.3% in T1HGN0, 77.5% to 87.8% in T2N0, 63.0% to 91.1% in T3N0, and 38.8% to 88.2% in T4N0/TanyN1-3. In MCR models, relative to T1LGN0, T1HGN0 (Hazard ratio [HR] 1.7), T2N0 (HR 3.0), T3N0 (HR: 5.2), and T4N0/TanyN1-3 (HR 11.9) were independent predictors of higher CSM. Conditional HRs decreased to levels equivalent to T1LGN0 at 3 years vs 5 years of event-free survival for T1HGN0 and all other groups, respectively. Conclusions: A direct relationship exists between event-free follow-up and survival probability after RNU. From a clinical perspective, such survival estimates may have particular importance during preoperative counseling.
disease stage; epidemiology; SEER database; survival benefit; tumor characteristics; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Nephroureterectomy; SEER Program; Survival Rate; United States; Ureter; Ureteral Neoplasms
Settore MED/24 - Urologia
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/881565
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